| Shoulder pain and shoulder injuries are one of the most | | | | Consultation and examination of an individual with |
| common presentations into my chiropractic practice. | | | | impingement syndrome or bursitis symptoms would |
| There are a multitude of reasons why people present | | | | include a thorough history, a physical exam, and other |
| with shoulder pain complaints. It is very important to | | | | tests such as imaging (x-rays or MRI) and neurological |
| thoroughly examine the shoulder and make an | | | | tests may be necessary. The most common |
| accurate diagnosis of the cause of the pain, so that | | | | approach to treating the shoulder pain with |
| the appropriate treatment plan can be directed at | | | | conservative management includes rest initially from |
| repairing and strengthening the shoulder joint. | | | | sports, work related activities, or heavy lifting, that may |
| It is a very common occurrence for a person to come | | | | have been part of the initial injury causing the irritation |
| and explain to me that they have been diagnosed with | | | | and inflammation. Ice, and alternating ice and heat |
| bursitis or tendinitis in the shoulder. "Itis" is another way | | | | combined may help to reduce or limit the inflammation. |
| of saying there is inflammation, in this particular case, | | | | Some gentle shoulder stretching, and strengthening |
| inflammation of the bursa or an area of the shoulder | | | | exercises may be added once the pain starts to |
| joint that is painful. When these problems occur | | | | reduce. |
| together, and because there is a limited amount of | | | | Chiropractic instrument adjustments and low force |
| space within the shoulder joint, the muscles and | | | | manual adjustments are a safe, effective and gentle |
| tendons become irritated and squeezed between the | | | | approach to mobilisation of the shoulder joint and the |
| humerus and the shoulder blade, "impinging" these | | | | associated rotator cuff tendons. This may help to |
| structures. Repetitive movements and stresses irritate | | | | increase circulation into the area, break down any |
| the tendons, muscles and associated soft tissues in | | | | adhesions in the joint area, gradually increase the range |
| the joint area. The symptoms of impingement | | | | of motion, and improve the exchange of nutrients |
| syndrome can be very mild or very severe. The fluid | | | | within the injured tissues to reduce inflammation and |
| filled bursa between tendon and bone, or tendon and | | | | accelerate the repair process. |
| skin, when inflamed is called bursitis. | | | | Individuals with shoulder bursitis normally respond to |
| Symptoms of impingement syndrome or bursitis usually | | | | conservative non-surgical treatments. The response |
| include a gradual onset of pain, most commonly in the | | | | time varies from person to person but usually a month |
| upper arm or shoulder region. Once irritated, the | | | | to three months is a normal timeframe for resolution of |
| tendons are easily inflamed and the swelling continues | | | | symptoms or significant improvement. A longer |
| to irritate and cause more pain and inflammation. | | | | timeframe may be required for a more optimal healing |
| Sleeping on their side or on the shoulder can be painful | | | | response. In severe cases where a person has not |
| and difficult. If the front area of the upper arm and | | | | responded to conservative care or there is advanced |
| shoulder area is involved, the biceps tendon may be | | | | damage to the involved area, shoulder surgery may be |
| exhibiting some tendinitis also. It is fairly common to see | | | | a necessary step. |
| pain referral to areas in the forearm and elbow also. | | | | |